Department of Psychology, University of Lethbridge, Lethbridge, AB, Canada.
Arch Sex Behav. 2010 Apr;39(2):514-45. doi: 10.1007/s10508-009-9594-3. Epub 2010 Feb 6.
The most widely used and influential typologies for transsexualism and gender identity disorder (GID) in adolescents and adults employ either sexual orientation or age of onset of GID-related symptoms as bases for categorization. This review compares these two typological approaches, with the goal of determining which one should be employed for the diagnosis of GID in Adolescents or Adults (or its successor diagnosis) in the forthcoming revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM). Typologies based on sexual orientation and age of onset of GID-related symptoms are roughly comparable in ease and reliability of subtype assignment. Typologies based on sexual orientation, however, employ subtypes that are less ambiguous and better suited to objective confirmation and that offer more concise, comprehensive clinical description. Typologies based on sexual orientation are also superior in their ability to predict treatment-related outcomes and comorbid psychopathology and to facilitate research. Commonly expressed objections to typologies based on sexual orientation are unpersuasive when examined closely. The DSM should continue to employ subtypes based on sexual orientation for the diagnosis of GID in Adolescents or Adults or its successor diagnosis.
最广泛使用和有影响力的跨性别和性别认同障碍（GID）的类型学在青少年和成年人中，要么以性取向，要么以 GID 相关症状的发病年龄为基础进行分类。本综述比较了这两种类型学方法，目的是确定在即将修订的《精神障碍诊断与统计手册》（DSM）中，哪种方法应该用于青少年或成年（或其后续诊断）的 GID 诊断。基于性取向和 GID 相关症状发病年龄的类型学在亚型分配的简便性和可靠性方面大致相当。然而，基于性取向的类型学采用的亚型不太模糊，更适合客观确认，并且提供更简洁、全面的临床描述。基于性取向的类型学在预测治疗相关结果和合并精神病理学以及促进研究方面也具有优势。当仔细检查时，通常对基于性取向的类型学表示的反对意见是没有说服力的。DSM 应继续为青少年或成年（或其后续诊断）的 GID 诊断使用基于性取向的亚型。
